A Nationwide Survey Following the Devastating 2022 Floods in Pakistan: Current State of Knowledge, Attitude, and Perception Toward Climate Change and Its Health Consequences.

BACKGROUND:  Climate change (CC) persists as a critical public health concern, vividly demonstrated by Pakistan's severe unprecedented flooding from June to October 2022. The interplay between floods and CC highlights the urgent need to comprehend their complex dynamics. Given Pakistan's significant geographical vulnerability to CC events, assessing public awareness of CC becomes essential. This study aims to evaluate public knowledge, attitudes, and perception (KAP) regarding CC and its implications for overall health, reflecting onto governmental policies and community-based guidelines and enhancing preparedness for future natural calamities of similar magnitude. METHODS:  A nationwide cross-sectional survey of Pakistani adults covering all provinces of the country was conducted from January to March 2023 using a prevalidated questionnaire. A purposive sampling strategy was used to enroll participants in the study. Where appropriate, the chi-square test or Fisher's exact test was used to compare KAP among the sociodemographic groups. Multivariate analysis was used to explore predictors of knowledge. Crude and adjusted odds ratios (ORs) were calculated considering a p value of ≤0.05 as significant. RESULTS:  Among the 714 respondents, 265 (37.1%) of the respondents' residential areas were affected by the floods in Pakistan. A total of 663 (92.9%) of the participants had heard of CC, with 302 (42.3%) choosing "social media/WhatsApp" as their source of information. Increased flooding and changes in rainfall patterns were selected by 679 (95.1%) and 661 (92.6%) participants, respectively, as the most recognized CC. "Deforestation" was the most indicated reason for CC by 675 (94.5%) participants. Multivariate analysis revealed that females (OR: 1.31, 95% CI: 1.16-2.00; p < 0.001), individuals who were affected by recent floods (OR: 1.13, 95% CI: 1.05-3.34; p = 0.003), and individuals who were medical students/healthcare workers (OR: 1.49, 95% CI: 1.24-2.48; p < 0.001) had greater knowledge of CC than their counterparts. CONCLUSIONS:  The study reported an encouraging prevalence of knowledge of CC, positive attitudes, and practices toward CC, with an interest in learning and doing more to address the health effects of CC. With the ongoing global CC and a monsoon season forecast of similar intensity for the years to come in Pakistan, identifying groups with less knowledge of CC warrants a targeted education program to maximize awareness. Based on the study findings, social media platforms and interventions in educational institutes should be essential to mitigate the CC events in Pakistan and other vulnerable regions in the area.

Impact of the Great East Japan Earthquake followed by the nuclear power plant accident on the nursing students' academic progress in Soma, Fukushima, Japan: a retrospective cohort study with questionnaire survey.

BACKGROUND: The Great East Japan Earthquake and the subsequent Fukushima nuclear power plant accident in 2011 posed significant challenges to the educational sector, particularly affecting nursing students in the disaster area. However, to the best of our knowledge, there are no reports on the effects of the natural disaster coupled with the nuclear accident on the nursing students. Therefore, this study aimed to determine the impact of the Fukushima disasters on rate of academic failure events in nursing education. METHODS: A retrospective cohort approach was conducted, focusing on 677 students from Soma Nursing School admitted between 2001 and 2017. Four failure events-failure to pass the national examination, student retention, suspension, and withdrawal from school-were compared between three time periods: pre-disaster, early peri-disaster, and later peri-disaster. This analysis was followed by a questionnaire survey among the students and an interview with faculty members to gain further insights. RESULTS: Of the student cohort, 17% had at least one failure event. Students in the later peri-disaster phase faced an elevated failure rate at 29%. Variables such as being male, admission during later peri-disaster period, and local pre-admission residence played a significant role in these failure events in multivariate logistic regression analysis (adjusted odds ratio [95% confidence interval, p value]; 2.63 [1.49-4.64, < 0.001], 3.207 [2.00-5.15, < 0.001], and 1.84 [1.12-3.02, 0.02], respectively). CONCLUSIONS: This study highlights the impact of the Great East Japan Earthquake and the following nuclear accident on nursing education. The elevated failure rates in the later peri-disaster period emphasize the challenges posed by continuing disaster phases. Thus, there is a need for intensified and tailored strategies in nursing education in disaster-affected regions.

Heterogeneous Trajectories in Post-Disaster Drug Use Across Different Race/Ethnicity and Income Strata: Focus on Natural Hazards During COVID-19.

During the COVID-19 pandemic, climate-related natural hazards, such as wildfires, storms/hurricanes, and others (e.g., earthquakes, tornadoes), further disrupted the normal functioning of US residents. The co-occurrence of natural disasters and COVID-19 created unprecedentedly elevated levels of stress, especially to the racial/ethnic minorities and lower-income households. This study examines how natural disasters related to recreational drug use during COVID-19 and whether the relation is heterogeneous across different subgroups categorized by race/ethnicity and household income. This study used the data from the biweekly online surveys of the Understanding America Study (UAS) and analyzed the drug use behaviors of 966 US adults between April 29 and December 31, 2020. This study found that middle-income adults (household income ranging from $50,000 to $149,999), serving as the reference group, generally exhibited a significant reduction in drug consumption during or after disaster events. However, compared to the middle-income group, White and Black adults with household income lower than $50,000 showed 142% and 88% more frequent drug use when experiencing storms/hurricanes. This disparity widened in the following weeks. Additionally, lower-income Hispanics showed 74% more frequent drug use compared to the middle-income group in the weeks following wildfire incidents. The study's findings shed light on the risk of drug misuse during the co-occurrence of climate and public health crises, emphasizing the disproportionate risk among lower-income racial/ethnic minorities amid the pandemic and natural disasters.

An integrated approach to analyze equitable access to food stores under disasters from human mobility patterns.

Limited access to food stores is often linked to higher health risks and lower community resilience. Socially vulnerable populations experience persistent disparities in equitable food store access. However, little research has been done to examine how people's access to food stores is affected by natural disasters. Previous studies mainly focus on examining potential access using the travel distance to the nearest food store, which often falls short of capturing the actual access of people. Therefore, to fill this gap, this paper incorporates human mobility patterns into the measure of actual access, leveraging large-scale mobile phone data. Specifically, we propose a novel enhanced two-step floating catchment area method with travel preferences (E2SFCA-TP) to measure accessibility, which extends the traditional E2SFCA model by integrating actual human mobility behaviors. We then analyze people's actual access to grocery and convenience stores across both space and time under the devastating winter storm Uri in Harris County, Texas. Our results highlight the value of using human mobility patterns to better reflect people's actual access behaviors. The proposed E2SFCA-TP measure is more capable of capturing mobility variations in people's access, compared with the traditional E2SFCA measure. This paper provides insights into food store access across space and time, which could aid decision making in resource allocation to enhance accessibility and mitigate the risk of food insecurity in underserved areas.

Optimal allocation of distributed energy resources to cater the stochastic E-vehicle loading and natural disruption in low voltage distribution grid.

The everyday extreme uncertainties become the new normal for our world. Critical infrastructures like electrical power grid and transportation systems are in dire need of adaptability to dynamic changes. Moreover, stringent policies and strategies towards zero carbon emission require the heavy influx of renewable energy sources (RES) and adoption of electric transportation systems. In addition, the world has seen an increased frequency of extreme natural disasters. These events adversely impact the electrical grid, specifically the less hardened distribution grid. Hence, a resilient electrical network is the demand of the future to fulfill critical loads and charging of emergency electrical vehicles (EV). Therefore, this paper proposes a two-dimensional methodology in planning and operational phase for a resilient electric distribution grid. Initially stochastic modelling of EV load has been performed duly considering the geographical feature and commute pattern to form probability distribution functions. Thenceforth, the impact assessment of extreme natural events like earthquakes using damage state classification has been done to model the impact on distribution grid. The efficacy of the proposed methodology has been tested by simulating an urban Indian distribution grid with mapped EV on DigSILENT PowerFactory integrated with supervised learning tools on Python. Subsequently 24-h load profile before event and after event have been compared to analyze the impact.

Enhancing natural disaster analysis and waste classification: a novel VGG-FL approach.

The study of natural disasters is a crucial field that involves analyzing the occurrence, impact, and aftermath of various natural hazards that can cause significant harm to communities and the environment. Efficient waste management and environmental protection require proper classification of waste. Analyzing natural disasters and categorizing waste can be a time-consuming task, and conventional methods often struggle with it. However, a new approach called Visual Geometry Group with Federated Learning (VGG-FL) has been introduced to address these challenges. This methodology uses the golden search optimization (GSO) algorithm for feature selection and leverages VGG with federated learning for feature extraction and classification. To test the effectiveness of this method, a disaster image dataset was used to train the VGG-FL model. The results showed that the VGG-FL model attained exceptional accuracy in discerning and categorizing various disaster scenarios. The waste classification dataset simultaneously trains the VGG-FL model to categorize waste based on its characteristics and potential hazards. To measure the model's performance, several evaluation metrics such as accuracy, specificity, precision, F1-score, and recall are utilized to assess the effectiveness of the proposed VGG-FL method. These results are then compared with existing methodologies. The VGG-FL method performs exceptionally well, achieving 98.52% accuracy, 97.48% precision, 97.83% recall, 97.58% F1-score, and 97.12% specificity. These experimental findings demonstrate the efficacy of the VGG-FL method in analyzing natural disasters and classifying waste materials.

High Rates of Honey Bee Colony Losses and Regional Variability in Ethiopia Based on the Standardised COLOSS 2023 Survey.

The COLOSS research association has been assessing honey bee colony losses, associated risk factors and management, focusing on Western countries but with a progressive international expansion. Here, we report the first survey on the loss rates of colonies in 2022/2023 in Ethiopia using COLOSS monitoring survey tools. A face-to-face interview questionnaire survey was conducted on 64 beekeepers selected from Oromia and Tigray regions. This covered 1713 honey bee colonies distributed in 68 apiaries. The percentages of colonies lost were significantly different between Oromia (24.1%) and Tigray (66.4%) regions. Colony losses were attributed as unsolvable queen problems (8% in Oromia; 10% in Tigray), natural disaster (32%; 82%), and empty hives or dead colonies (60%; 8%). The loss rate was significantly affected by queen replacement (p < 0.0001), use of natural comb (p < 0.0001), feed supplementation (p < 0.0001), region (p < 0.0001), varroa treatment (p < 0.0001), colony splitting (p < 0.01), and merging (p < 0.01). Beekeepers in Oromia managed more colonies and implemented improved practices compared to those in Tigray. However, all beekeepers in Oromia detected at least some bees with signs of deformed wing virus, compared to 76% of beekeepers in Tigray. In conclusion, the colony loss rate was significantly different between Oromia and Tigray regions due to differences in natural disasters, management, environment and health factors.

A longitudinal investigation of mental health outcomes after the Henan floods in China: Examining predictors of resilience trajectories.

A heavy rainstorm struck Henan, China, in July 2021. Previous studies have indicated that natural disasters have a wide range of psychological sequelae, but little research has been done on the psychological effects of floods specifically. This study aimed to track the mental health trajectories of flood victims over time and identify associated protective and risk factors. People living in the areas most impacted by the flood (N = 376) were surveyed at four different time points: 3 weeks, 1 month, 2 months, and 3 months post-flood. Latent growth mixture modeling was utilized to delineate longitudinal patterns of depression, anxiety, and posttraumatic stress disorder (PTSD). Least absolute shrinkage and selection operator logistic regression, a supervised machine-learning approach, was employed to discern predictors among 49 assessed variables at both contextual and personal levels. Results revealed three classes of PTSD (resilience, recovery, moderate symptoms) and anxiety (resilience, chronicity, recovery) trajectories, along with two classes of depression trajectories (resilience, chronicity). Key factors predicting resilience in mental health included personality traits, media consumption habits, pre-existing health conditions at the individual level, and asset loss and ongoing adversities at the contextual level. In spite of the widespread impact of the flood, most victims displayed resilience in the face of adversity. Identifying critical factors across various psychological symptoms offers valuable insights for both pre-disaster preparation and post-disaster trans-diagnostic psychological interventions.

Floods and cause-specific mortality in the UK: a nested case-control study.

BACKGROUND: Floods are the most frequent weather-related disaster, causing significant health impacts worldwide. Limited studies have examined the long-term consequences of flooding exposure. METHODS: Flood data were retrieved from the Dartmouth Flood Observatory and linked with health data from 499,487 UK Biobank participants. To calculate the annual cumulative flooding exposure, we multiplied the duration and severity of each flood event and then summed these values for each year. We conducted a nested case-control analysis to evaluate the long-term effect of flooding exposure on all-cause and cause-specific mortality. Each case was matched with eight controls. Flooding exposure was modelled using a distributed lag non-linear model to capture its nonlinear and lagged effects. RESULTS: The risk of all-cause mortality increased by 6.7% (odds ratio (OR): 1.067, 95% confidence interval (CI): 1.063-1.071) for every unit increase in flood index after confounders had been controlled for. The mortality risk from neurological and mental diseases was negligible in the current year, but strongest in the lag years 3 and 4. By contrast, the risk of mortality from suicide was the strongest in the current year (OR: 1.018, 95% CI: 1.008-1.028), and attenuated to lag year 5. Participants with higher levels of education and household income had a higher estimated risk of death from most causes whereas the risk of suicide-related mortality was higher among participants who were obese, had lower household income, engaged in less physical activity, were non-moderate alcohol consumers, and those living in more deprived areas. CONCLUSIONS: Long-term exposure to floods is associated with an increased risk of mortality. The health consequences of flooding exposure would vary across different periods after the event, with different profiles of vulnerable populations identified for different causes of death. These findings contribute to a better understanding of the long-term impacts of flooding exposure.

'School-based screen-and-treat': An effective blueprint for expediating access to care in children experiencing PTSD following disasters.

OBJECTIVES: While 5%-10% of children exposed to natural disasters develop PTSD, few children access support. This paper reports on the proactive 'screen-and-treat' approach deployed following devastating floods in Queensland, Australia, in 2011 and presents results for children in the Lockyer Valley (the most impacted community). DESIGN: Open treatment study (2011-2012) within a government-funded post-disaster service response. METHODS: One hundred and fifty children (7-12 years) completed pencil-and-paper screening (PTSD, anxiety and depression) at school. Eighty children endorsing either clinical levels of PTSD, or moderate levels of PTSD and clinical levels of either anxiety or depression, and their parents, completed a structured diagnostic interview. Forty-eight children were offered a free trauma-focused CBT intervention. The parents of 19 children accepted this offer. Most clinicians were clinical psychology trainees from local universities. All measures were repeated at post-treatment, 6- and 12-month follow-up. Note: The term 'parents' is used to refer to the wide variety of people serving as a child's primary caregiver. RESULTS: Pre-treatment, all children met diagnostic criteria for full (N = 17) or sub-clinical PTSD. By post-treatment, 10.5% met criteria for PTSD, with 0% meeting criteria at the 12-month follow-up. The incidence of anxiety and depressive disorders also reduced significantly. There were no differences in outcomes for children seen by trainees compared to experienced clinicians. CONCLUSIONS: A school-based screen-and-treat approach offers potential as a means of identifying and treating children following natural disaster exposure. However, engagement of families at the outset, and when offering intervention was challenging. Postgraduate trainees represent an effective potential workforce in a post-disaster environment.

"A Vulnerable Time To Be a Young Family in an Emergency": Qualitative Findings From an Exploration of an Emergency Perinatal and Infant Feeding Hotline in Louisiana.

BACKGROUND: Birthmark Doula Collective, a cooperative that provides doula and lactation services in the Greater New Orleans area, mounted an emergency response after two Category 4 storms: Hurricane Laura (2020) and Hurricane Ida (2021). The response included activating a no-cost emergency perinatal and infant feeding hotline. Both disasters coincided with a resurgence of COVID-19 infections in Louisiana. RESEARCH AIM: The aim of this study is to understand how an emergency perinatal and infant feeding hotline supported infant and young child feeding in emergencies during hurricanes in Louisiana. METHOD: This study used a cross-sectional, retrospective qualitative design in a population with low breastfeeding rates. We conducted a content analysis of 97 hotline call logs from Hurricanes Laura and Ida, focus groups with lactation support providers who staffed the hotline during either storm (n = 5), and interviews with mothers who called during Hurricane Ida (n = 2). Focus groups and interviews lasted 30 and 60 minutes, respectively. Transcripts were analyzed using thematic analysis techniques. RESULTS: Call logs revealed infant feeding needs (e.g., mastitis, low milk supply, relactation, and infant formula requests) and non-infant feeding needs (e.g., infant supplies, perinatal and infant care referrals, shelter information). Infant formula was the most requested supply during both hurricanes. Maternal participants discussed family vulnerabilities during Hurricane Ida. Staff described training and strategies to provide support while maintaining their own well-being. CONCLUSION: Providing a free emergency hotline service is one way to support pregnant and postpartum people and their families seeking infant feeding advice, supplies, and support in the immediate aftermath of a disaster.

The prevalence of prolonged grief disorder (PGD) after the natural disasters: A systematic review and meta-analysis.

Objective: The failure to detect PDG and lack of providing essential interventions accordingly can disrupt the lives of survivors of natural disasters years after the death of their loved ones. The present study aims to investigate PGD after natural disasters using a systematic review and meta-analysis. Study design: This study was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Methods: With the focus on the prevalence of PGD after natural disasters, studies conducted until the end of 2021 were collected without a time limit. To do this, reputable databases such as PubMed, Web of Science, Scopus, Embase, Google Scholar, and Science Direct were used. The random effects model was used to perform a meta-analysis of the studies. To check the heterogeneity between the studies, the I2 index was used. The publication bias of the study was evaluated using Begg's test. Data were analyzed using the STATA software. Results: Primarily, 2566 studies were collected based on the initial search, from which 12 final studies were entered into the analysis. The results showed that the prevalence of PGD after natural disasters was 38.81 % (95 % CI: 24.12-53.50, I2 = 99.7 %, p = 0 < 001). Conclusions: It is recommended that policies and plannings of the organizations responsible for disaster management be prepared to send specialized teams of psycho-spiritual counseling, quickly accommodate the injured, and reconstruct the damaged buildings in the shortest time possible.

From Tragedy to Resilience in a University Hospital: Characteristics of Patients in the Aftermath of the 2023 Turkey Earthquake.

OBJECTIVE: This study focuses on adults affected by the February 2023 Turkey earthquakes, aiming to uncover demographic and clinical traits. METHODS: A retrospective analysis of data from adult patients who sought emergency care between February 6 and February 21, 2023, following the earthquakes, was conducted. RESULTS: Among 3072 patients, 1544 (50.3%) of whom were women, trauma (31.1%) was the most prevalent cause of emergency department presentations. The median age of all patients was 44 y (interquartile range [IQR] 31-61 y). Hatay province accounted for 65.2% of trauma patients as origin. Most of the patients (66.8%) presented to the emergency department by their own means, while this was opposite for trauma patients, of whom 54.5% was transferred by means of Ambulance Service. Half of the total trauma patients were rescued from the debris, and 75.9% sustained limb injuries. Crush syndrome affected 24.7%, and emergency hemodialysis was performed on 9.1%, whereas emergency surgery was performed on 22.8% of all trauma cases. Overall, 10.2% of trauma patients lacked any identification. The rate of emergency department admittions due to respiratory and cardiovascular diseases was higher at the time of the earthquake compared with the previous year (P < 0.001). CONCLUSIONS: The insights gained from this study hold valuable implications for disaster response strategies, emphasizing the importance of preparedness, timely intervention, and comprehensive patient care.

Evaluation of the demographic characteristics and general health status of earthquake survivors affected by the 2023 Kahramanmaras earthquake; a section from Gaziantep Nurdagi district.

BACKGROUND: An earthquake with a magnitude of 7.7 occurred in Pazarcik District of Turkey at 04.17 on February 6, 2023 and another earthquake of 7.6 occurred at 13.24 on the same day. This is the second largest earthquake to have occurred in Turkey. The aim of this study is to investigate the earthquake-related level of knowledge, attitudes and behaviours, general health and psychological status of survivors who were affected by the 2023 Kahramanmaras Earthquake and who were living in Nurdagi District of Gaziantep after the earthquake. METHODS: Data of 2317 individuals older than 18 years of age who were living in earthquake neighbourhoods, tents and containers in Nurdagi District of Gaziantep were examined. Variables were evaluated to find out the demographic characteristics and general health status of earthquake victims. General Health Questionnaire (GHQ-12) was used to find out psychological states of earthquake victims. RESULTS: The rate of injuries was 14.2% and leg and foot injuries were the most common with 44.2%. The relationship between injury status; and age, marital status, and being trapped under debris was revealed (p < 0.05). Mean GHQ-12 score of the survivors was 3.81 ± 2.81 and 51.9% experienced psychological distress. In the evaluation with logistic regression, it was found that female gender, being injured in the earthquake, loss of first degree and second degree relatives (with a higher rate in loss of first degree relative), having a severely damaged -to be demolished house and having a completely destroyed house were correlated with higher level of psychological distress (p < 0.05). CONCLUSION: General characteristics, injury prevalence and affecting factors of earthquake survivors were evaluated in the present study. Psychological distress was found in victims. For this reason, providing protective and assistive services to fight the destructive effects of earthquake is vital. Accordingly, increasing the awareness of people residing in earthquake zones regarding earthquakes is exceptionally important.

Changes in physical activity during the year after the Great East Japan Earthquake and future frailty in older survivors.

AIM: This study examines whether changes in physical activity (PA) during the first year after the Great East Japan Earthquake and Tsunami (2011-2012) contributed to preventing the onset of future frailty among older survivors of the disaster. METHODS: This study tracked 2561 physically active Japanese survivors aged ≥ 65 years (43.6% men; mean age 72.9 years) who had completed self-administered questionnaires in 2011 and 2012. PA levels for participants were classified into four categories based on ≥23 and <23 metabolic equivalent hours/week in 2011 and 2012: "consistently low," "decreasing," "increasing," and "consistently high." Frailty was defined as a Kihon Checklist score ≥ 5, which is used in the long-term care insurance system in Japan. Hazard ratios were calculated for the onset of frailty using a Cox proportional hazards model that fitted the proportional sub-distribution hazards regression model with weights for competing risks of death. RESULTS: From 2012 to 2018, 283 men and 490 women developed frailty. Men with consistently high or increasing PA during the first year after the disaster had a lower risk of frailty. Furthermore, even increasing PA by walking for just 30 min/day prevented future frailty in men; however, this association between a change in PA and the decreased risk of frailty was not observed in women. CONCLUSIONS: Older men who remained physically active or resumed PA at an early stage and at a low intensity, even after being physically inactive owing to the disaster, were able to prevent future frailty. Geriatr Gerontol Int 2024; 24: 563-570.

Young people's experiences of the Northern Rivers 2017 flood and its effects on their mental health.

OBJECTIVE: To explore young people's (YP) experiences of catastrophic flooding in the Northern Rivers area of northern NSW in 2017 and its effect on their mental health. DESIGN: Content analysis of free-text survey responses (written responses to open questions, rather than selecting a response option). SETTING: Northern Rivers NSW. PARTICIPANTS: YP aged 16-25 years who were Northern Rivers residents at the time of the 2017 flood. RESULTS: YP found their flood experience to be novel and challenging. They expressed worry, distress, anxiety, and worsened pre-existing mental health issues as a result of the flood. YP reported a number of primary stressors (inadequate preparedness, warning and support during the flood) and secondary stressors (loss/damage of property and possessions, financial strain and disruptions to daily life) which potentially contributed to poor mental health. Some YP reported positive outcomes from their flood experience, notably increased community connectedness and personal resilience. However, they also expressed concern for the future, particularly potential reoccurrence of extreme floods as well as climate change. YP conveyed a desire for better community involvement to improve preparedness for future floods and a clear motivation to take action on climate change. CONCLUSION: The flood was a challenging experience for YP which was commonly described as negatively affecting their mental health. Understanding what YP view as significant events or issues arising from their personal flood experience may help target support mechanisms and services to maintain their mental. More focus on community-based initiatives to improve disaster preparedness can support mental health in YP.

Devastating Wildfires and Mental Health: Major Depressive Disorder Prevalence and Associated Factors among Residents in Alberta and Nova Scotia, Canada.

Background: Since March 2023, hundreds of fires have burned from coast to coast throughout the country, placing Canada on track to have the worst wildfire season ever recorded. From East to West, provinces such as Quebec, Ontario, Nova Scotia, Alberta, and British Columbia have been particularly affected by large and uncontrollable wildfires. Objectives: The objective of this study was to determine the prevalence of depression symptoms and predictors among residents living in extreme climate conditions during the Canadian wildfires of 2023 in Alberta and Nova Scotia and to update the literature with data related to those wildfires. Methods: A cross-sectional quantitative survey was conducted in this study. REDCap was used to administer an online survey between 14 May and 23 June 2023. Through the Text4Hope program, participants subscribe to receive supportive SMS messages daily. As part of the initial welcome message, participants were invited to complete an online questionnaire, containing demographic information, wildfire-related information, and responses to the Patient Health Questionnaire-9 (PHQ-9) for depression assessment. SPSS version 25 was used to analyze the data. Descriptive, univariate, and multivariate regression analyses were employed. Results: A total of 298 respondents completed the survey out of 1802 who self-subscribed to the Text4Hope program in Alberta and Nova Scotia and received a link to the online survey, producing a response rate of 16.54%. Most of the respondents were females (85.2%, 253), below 40 years of age (28.3%, 84), employed (63.6%, 189), and in a relationship (56.4%, 167). A historical depression diagnosis (OR = 3.15; 95% CI: 1.39-7.14) was a significant predictor of moderate to severe MDD in our study. The unemployed individuals were two times more likely to report moderate to severe symptoms of MDD than employed individuals (OR = 2.46; 95% CI: 1.06-5.67). Among the total sample population, the moderate to severe MDD prevalence was 50.4%, whereas it was 56.1% among those living in areas affected by wildfires. Conclusion: Based on our study findings, unemployment and a history of depression diagnosis were independently significant risk factors associated with the developing moderate to severe MDD symptoms during wildfire disasters. Further research is required to identify robust predictors of mental health disorders in disaster survivors and provide appropriate interventions to the most vulnerable communities and individuals.

kppmenet: combining the kppm and elastic net regularization for inhomogeneous Cox point process with correlated covariates.

The kppm is a standard procedure to estimate the parameters of the inhomogeneous Cox point process. However, the procedure cannot handle the problem when the models involve correlated covariates. In this study, we develop the kppmenet, the modified version of the kppm, for the inhomogeneous Cox point process involving correlated covariates by considering elastic net regularization. We compare the methodology in a simulation study and apply it to model major-shallow earthquake distribution in Sumatra, Indonesia. We conclude that the kppmenet outperforms kppm when correlated covariates are involved.

Exposure to earthquakes and development of ischemic heart disease.

BACKGROUND: The evidence regarding the effect of earthquake exposure on the development of cardiovascular diseases is limited. This study evaluated the association between the 2016 Gyeongju earthquake, which had a magnitude of 5.8, and over 600 subsequent aftershocks occurring within a year in Korea, with the development of ischemic heart disease (IHD) among residents of Gyeongju. METHODS: Ten years (2010-2019) of medical records from a randomly selected cohort of residents (n = 540,858) in Gyeongju and 3 control cities were acquired from the national health insurance service. Employing difference-in-difference and meta-analyses, the risks of IHD development of Gyeongju residents before (reference: Sep 2014 to Aug 2015; period 1: Sep 2015 to Aug 2016) and after (period 2: Sep 2016 to Aug 2017; period 3: Sep 2017 to Aug 2018; period 4: Sep 2018 to Aug 2019) the earthquake were estimated. RESULTS: The monthly average incidence of IHD in Gyeongju was 39.5 persons (per 1,000,000) for reference period and 38.4 persons for period 1. However, the number increased to 58.5 persons in period 2, and 49.8 persons in period 3, following the earthquake. The relative risk (RR) [with a 95% confidence interval] of developing IHD among Gyeongju residents increased by 1.58 times (1.43, 1.73) in period 2, 1.33 times (1.21, 1.46) in period 3, and 1.15 times (1.04, 1.27) in period 4, in comparison to both the control cities and the pre-earthquake reference period. The increase in RR was particularly noticeable among women, adults aged 25-44, and individuals with lower incomes. CONCLUSIONS: The major earthquake in Korea was associated with an increase in the development of IHD among local residents. Individuals exposed to earthquakes may benefit from cardiovascular health surveillance.